• 제목/요약/키워드: Hypertension Monitoring

검색결과 93건 처리시간 0.029초

본태성 고혈압환자를 위한 자기조절 프로그램 관련요인 연구 (A Study on the Factors Affecting Self-Regulation Program for Hypertensives)

  • 박영임
    • 지역사회간호학회지
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    • 제6권2호
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    • pp.234-249
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    • 1995
  • Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.

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소아 비만아에서 ambulatory blood pressure monitoring의 유용성 (The utility of ambulatory blood pressure monitoring in obese children)

  • 김명진;송진영
    • Clinical and Experimental Pediatrics
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    • 제51권6호
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    • pp.604-609
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    • 2008
  • 목 적 : 비만은 고혈압의 위험 인자로서 소아 청소년기의 비만이 성인기의 비만으로 발전하기 때문에 결국 소아 청소년기의 비만으로 심혈관계 등 여러 문제가 유발된다고 볼 수 있다. 따라서 소아 청소년기 비만증에서 정확한 혈압의 측정은 매우 중요하겠다. 본 연구에서는 소아 청소년 비만 환자들을 대상으로 수시 혈압 측정으로 선별 검사한 후 이들의 24시간 혈압을 측정함으로 ABPM의 유용성과 의미에 대해 고찰해보고자 하였다. 방 법 : 2006년 2월 1일부터 2007년 12월 1일까지 한동대학교 선린병원의 소아 청소년과를 방문하여 ABPM을 시행한 모든 환자들을 대상으로 하였다. 자료의 분석은 수축기, 이완기 혈압측정을 수면 혈압과 이를 제외한 각성 혈압으로 나누어 분석하였고 야간 혈압 강하(night dip)를 평가하였다. 환자는 정상군(1군)과 체질량계수만 95 백분위수가 넘는 비만군(2군) 그리고 비만이면서 외래혈압이 120/80 mmHg이상인 비만 위험혈압군(3군)으로 구분하였다. 결 과 : ABPM을 시행한 환자는 모두 49명이었고 비만군이 18명이었고 비만 위험혈압군이 12명이었다. 정상군은 19명이었다. 각 군의 수축기 평균혈압을 비교하였을 때 모든 군에서 통계학적으로 의미 있는 차이를 나타내었고(1군, $105.1{\pm}4.7$; 2군, $111.0{\pm}7.1$; 3군, $117.8{\pm}6.6mmHg$), 이완기 평균 혈압의 경우 1군과 3군에서만 통계학적으로 의미 있는 차이를 나타내었다($69.1{\pm}5.3$, $77.9{\pm}6.3mmHg$). 각성 혈압을 비교한 결과도 1군과 3군간에만 통계적으로 유의한 차이가 있었다. 수면혈압인 경우 수축기 혈압은 3군이 1, 2군에 비해 통계적으로 유의하게 높았으나, 이완기 혈압은 다른 경우와 마찬가지로 1군과 3군간에만 유의한 차이가 있었다. 본 연구에서 각 군간에 야간 혈압 강하를 조사해보니 통계적으로 의미 있는 차이를 보이지 않았다. 결 론 : 본 연구에서 ABPM을 시행한 결과 비만 위험혈압군에서 통계적으로 유의하게 혈압이 높았다. 소아 청소년에서, 특히 향후 심혈관 질환 및 여러 질환의 위험인자로 알려진 비만아에서 ABPM의 적극적인 활용이 필요로 하겠다.

Efficacy of Low Dose Barbiturate Coma Therapy for the Patients with Intractable Intracranial Hypertension Using the $Bispectral^{TM}$ Index Monitoring

  • An, Hung-Shik;Cho, Byung-Moon;Kang, Jeong-Han;Kim, Moon-Kyu;Oh, Sae-Moon;Park, Se-Hyuck
    • Journal of Korean Neurosurgical Society
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    • 제47권4호
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    • pp.252-257
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    • 2010
  • Objective : Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with $Bispectral^{TM}$ index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. Methods : We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. Results : The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were $0.63{\pm}0.26$ in low dose group, and $1.31{\pm}0.48$ in high dose group. The treatment durations were $4.89{\pm}1.68$ days and $3.38{\pm}1.24$ days in low dose BCT and high dose BCT, respectively. Conclusion : It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.

본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증- (An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory-)

  • 박영임;홍여신
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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일부 보건소 고혈압·당뇨관리교실 연계 구강건강증진 프로그램 운영 및 평가: 논리적 모형을 이용하여 (Evaluation of Oral Health Promotion Program Connected with Hypertension and Diabetes Management Programs: Use of a Logical Model)

  • 유상희;신보미;배수명;신선정
    • 치위생과학회지
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    • 제16권4호
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    • pp.293-301
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    • 2016
  • 본 연구는 강릉시보건소 고혈압 당뇨관리사업과 구강보건사업을 연계한 통합건강증진사업을 기획, 수행하고 단계적 평가지표를 제시하여, 고혈압 당뇨관리교실에 등록한 30세 이상의 성인 중 48명을 대상으로 진료실 개별 구강건강관리 프로그램을 운영하였다. 인력 시설 장비 등의 구조평가와 담당자의 적절성 및 프로그램 운영 충실도 등의 과정평가를 통해 사업의 기획 및 수행상태를 파악할 수 있었으며, 개선방안 모색을 통해 사업의 효율성을 높일 수 있었다. 결과평가 결과로 '구강건강지식'은 8점 만점에 1차 5.52점, 2차 7.42점으로 나타났으며(p<0.001), '구강건강인식'은 20점 만점에 1차 13.31점, 2차는 17.29점으로(p<0.001) 지식과 인식 문항 모두 1차에 비해 2차 점수가 유의한 차이로 높게 나타났다. '치은출혈' 검사 결과 1차 '출혈 있음'이 89.1%, 2차 71.7%로 감소하였으며(p=0.021), 'PHP index' 검사 결과 1차 3.28점, 2차 2.42점으로 유의한 차이가 있었다(p<0.001). 프로그램의 전체적인 만족도는 '매우 만족, 만족'이 98.0%, 재참여 의사 및 권유 의사는 '매우 그렇다, 그렇다'가 각 97.9%, 93.7%로 매우 높게 나타났다. 사업담당자 1:1 면접설문조사를 통한 질적 평가 결과, 프로그램의 '전체적인 구성의 적절성'은 내용이 짜임새있게 구성되어 '매우 적절, 적절'이라고 응답하였으며, '연계 절차의 적절성'은 현황 및 요구도 조사에서 대상자의 위험요인을 적절히 파악하여 연계가 이루어졌으며, 당뇨와 치주질환의 연관성에 따라 사업을 연계하여 운영하는 것이 '적절'하다고 응답하였다. '성과지표의 적절성'으로는 '참여 인원수, 효과성(치은출혈, PHP index, 구강건강지식 및 인식), 만족도 평가'가 성과지표로 '매우 적절, 적절'하다고 응답하였다. 논리적 모형의 사업은 투입-활동-산출-결과에 따라 구조, 과정, 결과 평가지표로 구조화되어 단계적 평가가 이루어지기 때문에 균형적인 평가가 가능하며, 평가지표는 정량적 지표와 정성적 지표로 구성되어 체계적인 사업 평가가 이루어질 것으로 생각된다. 고혈압 당뇨관리교실 내소자의 통합적 건강관리를 위해 본 연구에서 기획된 개별 관리 프로그램과 평가지표의 적용 확대 가능성이 높을 것으로 생각되며, 논리적 모형을 적용한 프로그램의 일반적인 적절성과 평가지표의 타당성을 확인하고, 만성질환 관리 측면에서 공통의 효과를 측정할 수 있도록 지속적인 운영과 모니터링이 필요할 것으로 생각된다.

Association Between Leisure Time Physical Activity, Cardiopulmonary Fitness, Cardiovascular Risk Factors, and Cardiovascular Workload at Work in Firefighters

  • Yu, Clare C.W.;Au, Chun T.;Lee, Frank Y.F.;So, Raymond C.H.;Wong, John P.S.;Mak, Gary Y.K.;Chien, Eric P.;McManus, Alison M.
    • Safety and Health at Work
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    • 제6권3호
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    • pp.192-199
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    • 2015
  • Background: Overweight, obesity, and cardiovascular disease risk factors are prevalent among firefighters in some developed countries. It is unclear whether physical activity and cardiopulmonary fitness reduce cardiovascular disease risk and the cardiovascular workload at work in firefighters. The present study investigated the relationship between leisure-time physical activity, cardiopulmonary fitness, cardiovascular disease risk factors, and cardiovascular workload at work in firefighters in Hong Kong. Methods: Male firefighters (n = 387) were randomly selected from serving firefighters in Hong Kong (n = 5,370) for the assessment of cardiovascular disease risk factors (obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, known cardiovascular diseases). One-third (Target Group) were randomly selected for the assessment of off-duty leisure-time physical activity using the short version of the International Physical Activity Questionnaire. Maximal oxygen uptake was assessed, as well as cardiovascular workload using heart rate monitoring for each firefighter for four "normal" 24-hour working shifts and during real-situation simulated scenarios. Results: Overall, 33.9% of the firefighters had at least two cardiovascular disease risk factors. In the Target Group, firefighters who had higher leisure-time physical activity had a lower resting heart rate and a lower average working heart rate, and spent a smaller proportion of time working at a moderate-intensity cardiovascular workload. Firefighters who had moderate aerobic fitness and high leisure-time physical activity had a lower peak working heart rate during the mountain rescue scenario compared with firefighters who had low leisure-time physical activities. Conclusion: Leisure-time physical activity conferred significant benefits during job tasks of moderate cardiovascular workload in firefighters in Hong Kong.

Trend Analysis in the Prevalence of Type 2 Diabetes According to Risk Factors among Korean Adults: Based on the 2001~2009 Korean National Health and Nutrition Examination Survey Data

  • Kim, Young-Ju;Lim, Myoung-Nam;Lee, Dong-Suk
    • 대한간호학회지
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    • 제44권6호
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    • pp.743-750
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    • 2014
  • Purpose: The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey. Methods: Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2. Results: Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group. Conclusion: Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.

고혈압환자를 위한 자조관리 프로그램의 효과 (The Effect of Self-help Programs for Hypertensives in Community Areas)

  • 박남희
    • 보건교육건강증진학회지
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    • 제20권3호
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    • pp.207-219
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    • 2003
  • This study was conducted to identify the effects of the comprehensive nursing aided self-help program for hypertensives. The program educates hypertensives in community areas about blood pressure, self-care, health promoting behaviors, and life satisfaction. For this purpose a one group time series design was used. Sixteen subjects were evaluated from S Community Health center of B city. Self-help programs developed by the author were given to the subjects. The program consisted of group education on hypertension and self-care including blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-help. The whole program was carried out from October to December in 2002. Data was analyzed by repeated measure ANOVA, and post-hoc Turkey. The results were as follows: There were significant relationships between changes in systolic pressure(F=10.638. P=.000), diastolic pressure(F=6.783. p=.013), self-care(F=13.506. p=.000), and health promoting behavior(F=9.067. p=.001) at the 6th week and the 9th week. There were no significant relationships between changes in life satisfaction at the 6th week or 9th week. From these results, it can be concluded that the self-help program is an effective nursing strategy to promote self-care of hypertensives in community areas.

PTT를 이용한 운동 중 혈압 예측을 위한 Local과 Global Fitting의 비교 (Comparison of Local and Global Fitting for Exercise BP Estimation Using PTT)

  • 김철승;문기욱;엄광문
    • 전기학회논문지
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    • 제56권12호
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    • pp.2265-2267
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    • 2007
  • The purpose of this work is to compare the local fitting and global fitting approaches while applying regression model to the PTT-BP data for the prediction of exercise blood pressures. We used linear and nonlinear regression models to represent the PTT-BP relationship during exercise. PTT-BP data were acquired both under resting state and also after cycling exercise with several load conditions. PTT was calculated as the time between R-peak of ECG and the peak of differential photo-plethysmogram. For the identification of the regression models, we used local fitting which used only the resting state data and global fitting which used the whole region of data including exercise BP. The results showed that the global fitting was superior to the local fitting in terms of the coefficient of determination and the RMS (root mean square) error between the experimental and estimated BP. The nonlinear regression model which used global fitting showed slightly better performance than the linear one (no significant difference). We confirmed that the wide-range of data is required for the regression model to appropriately predict the exercise BP.

WBAN 환경에서 응급 정보의 안정적 전송을 위한 프로토콜 설계 및 구현 (Design and Implementation of a protocol for stable transmission of emergency information in WBAN environment)

  • 이동호;왕종수
    • 디지털산업정보학회논문지
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    • 제6권4호
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    • pp.57-65
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    • 2010
  • Application of WBAN technology in medical field facilitates the prevention of diseases by collecting the vital signs remotely. It also enables to prevent the accidental emergency situation in advance plus long-tem monitoring of patients with chronic diseases such as heart diseases, hypertension, or the elderly and infirm. For emergency patients, major vital signal information collected by the 'Sensing' should have the top priority and such information should be transferred as promptly as possible without competition. In addition, when an emergency occurs to a patient, a priority mechanism is necessitated for a urgent message to get through to the final destination. However, LR-WPAN IEEE 802.15.4 technology does not consider such emergency message handling features. To deal with aforementioned issues, the IEEE 802.15.4 super frame protocol structure has been designed for stable transfer of emergency information in WBAN environment in this study, and alternation to super frame structures have been made, allowing GTS(Guaranteed Time Slot) can be used first at CFP (Contention Free Period) by reserving the resources in advance and prioritize the emergency signals. NS-2 has been utilized for the performance test and analysis.